This invention relates to a device and method for the repair of ducts in a living body, for example the arterial system. It has been long recognized both in the medical profession and others that damage to a portion of the arterial system which carries blood from the heart to the various parts of the body is a significant cause of disability and death. Of particular concern are aneurysms and blockages in the aorta, the main trunk of the arterial system, the trunk that conveys blood from the left ventrical of the heart to all of the body except the lungs.
Significant advances have been made in recent years in medical and surgical arts towards the solution of this problem. One such solution is directed towards a procedure where a portion of the artery or aorta, in which the aneurysm occurs, is cut away or "resected" and a tubular "graft" is substituted for the resected segment. Generally this graft is a fabric tube, corresponding in diameter to the resected artery segment. After the tube or graft is set in place, it is then sutured at its opposite ends to the adjacent edges of the artery. More recent advances in the medical and surgical art in this area have employed a graft and a method of using it which obviates the necessity of resection and which utilizes the arterial walls of the segment containing the aneurysms or other defects to reenforce and strengthen the graft. Such a solution is shown in U.S. Pat. No. 4,190,909, which discloses a prosthetic graft in the form of a flexible tube with a rigid end portion, each of the rigid end portions having an annular groove therein. The graft is used by slitting a portion of an artery containing an aneurysm or other damage to form an opening, inserting the graft through the opening into the artery, positioning the graft longitudinally within the artery, and circumferentially ligating the artery against the grooves in the rigid end portion of the graft. This procedure requires that the graft be inserted inside of the artery and the artery sutured around the graft. When the known prior art method and apparatus is used, it can only be employed when the artery is dilated, as in the case of an aneurysm of an artery. It cannot be employed when the artery is partially or completely blocked due to narrowing of its lumen from clots or arteriosclerosis.
When narrowing or blockage occurs in a duct such as an artery or vein, prior art prosthetic grafts are placed outside the artery and connected to the artery at both ends with manually applied sutures. In dealing with very narrow or small sized arteries (one millimeter in diameter or less) this suturing sometimes is accomplished by means of a glue. In larger arteries like the aorta, manual suturing has to be done to make the connections between the ends of a prosthetic graft and the artery. This suturing is sometimes technically difficult and time consuming and requires prolonged clamping of the artery during suturing to prevent blood loss, with obvious resulting adverse effects.
Contrary to the known prior art, the present invention is one that provides a multi-anchored connection between the artery and the prosthetic graft. It is particularly useful where the prosthetic graft, shown in U.S. Pat. No. 4,190,909, cannot be used because the graft must be placed outside an artery which is substantially blocked. The present invention minimizes the time required in making a connection between a body tube (like an artery) and the prosthetic graft thereby minimizing the blood flow interruption to the body organs otherwise supplied by the artery. This greatly reduces the complications due to the lack of blood supply.
The present invention also makes it technically easier to make a connection between a body tube and the prosthetic graft, so that a less experienced surgeon may make a connection with skill and confidence.
The prior art disclosed prosthetic graft basically had two anchoring positions, one at one end of the graft and one at the other plus some anchoring that arose out of the suturing used to close the duct after the graft had been inserted. In the present invention, there are no less than six anchoring points to securely affix the grafts and reduce the risk of migration of the graft as a result of body movements and blood flow therethrough.